NPI 1477288579 · Physician · Anthem
Strong multi-source corroboration of active practice across 3 carrier networks with confirmed Colorado DORA license.
NPPES
PALMER LAKE, 80133
Freshness: Unknown
Network Status
Listed with 3 carriers
DORA License
Active
Medicare
Non-Medicare specialty
Care Compare
No Care Compare data
PECOS Enrollment
No PECOS data
Active NPI with specialty classification
Active Colorado DORA license confirmed
No Medicare billing · No electronic endpoint · No PECOS enrollment
Single address source (NPPES)
Limited carrier network presence
3 networks across 2 carriers
Disclaimer: This analysis uses publicly available federal and state data sources. It does not constitute a determination of provider status or network participation. Contact the provider or health plan directly to verify current status.